Appropriateness of the Lab Utilization in PHCs, Riyadh, Saudi Arabia

Abstract

Background: After years of steady growth, laboratory test demands have surpassed those of any other medical act; therefore, it is critical to ensure that the requested testing is appropriate. This study aimed to assess the rate of overutilization of HBA1C, TSH, and Vitamin D tests among family physicians in a tertiary care hospital and primary care centers in Saudi Arabia. Methods: This was a cross-sectional chart review study conducted at Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia. A structured data collection form was designed to collect data that fulfill the study objectives. Data were collected by the study authors through reviewing their files and lab investigations. To determine whether tests are over utilized or not, we followed certain criteria’s for each test. Latest American Diabetes Association (ADA) was followed for HBA1C. For TSH test, we followed latest guidelines of American Thyroid Association (ATA). American Society for Clinical Pathology guidelines was followed for Vitamin D. Results: Data of a total of 380 patients was analyzed. The rate of overutilization was the highest for vitamin D at 57.14% followed by TSH at 40.47%, and HbA1c at 25.98%. When the rate of overutilization was calculated by the physician degree it differed significantly only with HbA1c, being the highest among SHO at 50%, with a P-value of <0.001. There were no significant differences in the overutilization rates of the studied lab tests by physicians’ nationality or gender. Conclusion: The rates of the overutilization of the studied lab tests (HbA1c, TSH, and vitamin D) are considered high, particularly Vitamin D.